Table of ContentsView AllTable of ContentsSurgeryRadiationChemotherapyHormone TherapyTargeted TherapyImmunotherapyTreatment Disparities
Table of ContentsView All
View All
Table of Contents
Surgery
Radiation
Chemotherapy
Hormone Therapy
Targeted Therapy
Immunotherapy
Treatment Disparities
Breast cancer treatment has evolved in recent years with a growing number of hormone therapies, targeted drugs, and immunotherapies supporting more traditional approaches, like surgery, radiation, and chemotherapy.
Due to these and other advances, the overallfive-year survival rateforbreast canceris 96%, meaning that 96 out of every 100 newly diagnosed women will live forat leastfive years.With newer drugs in the pipeline—including those better able to cure or managetriple-negative breast cancermore common in Black women—researchers are hoping to extend survival rates even further.
3:01
A Note on Gender and Sex TerminologyVerywell Health acknowledges thatsex and genderare related concepts, but they are not the same. To accurately reflect our sources, this article uses terms like “female" and “women” as the sources use them.
A Note on Gender and Sex Terminology
Verywell Health acknowledges thatsex and genderare related concepts, but they are not the same. To accurately reflect our sources, this article uses terms like “female" and “women” as the sources use them.
Breast Cancer Surgery
Surgery may also be used to reconstruct the breast after surgery or relieve symptoms in people withmetastatic breast cancer(where cancer has spread beyond the primary site).
Breast-Conserving Surgery
Depending on how much tissue is removed, the surgery may also be calledquadrantectomy, partial mastectomy, or segmental mastectomy.
Mastectomy
Amastectomyinvolves surgical removal of the entire breast. A bilateral or doublemastectomyis when both breasts are removed. Sometimes other tissues, such as the muscle lying behind the breast, are removed as well.
Mastectomy is not reserved only for women who have breast cancer; it is sometimes performed for those who are at high risk of developing breast cancer.
While mastectomy may be the only option for some women, others may pursue it to reduce the chance of cancer coming back. Whether this is needed is debatable. Studies have shown that, when used appropriately forearly-stage cancer, BCS with radiation offers the same survival rate as mastectomy.
Axillary Lymph Node Resection
One of two types of surgery may be used to remove (resect) lymph nodes under your arm to see if they contain cancer cells:
The resection and evaluation of lymph nodes help withcancer staging and grading(the process used to determine how advanced and aggressive a cancer is). The resection may be performed as part of breast cancer surgery or on its own.
Breast Reconstruction
There are three surgeries commonly used:
Other procedures may be used to reconstruct the nipple or improve the overall look of the breast.
As beneficial as breast reconstruction is, the cost of the procedures can be prohibitive. Compared to White women in the United States, Black women are 36% to 71% less likely to pursue breast reconstruction due to cost.
Breast Cancer Doctor Discussion GuideGet our printable guide for your next doctor’s appointment to help you ask the right questions.Download PDFEmail AddressSign UpThank you, {{form.email}}, for signing up.There was an error. Please try again.
Get our printable guide for your next doctor’s appointment to help you ask the right questions.
Download PDF
Email AddressSign UpThank you, {{form.email}}, for signing up.There was an error. Please try again.
Sign Up
Thank you, {{form.email}}, for signing up.
There was an error. Please try again.
Radiation Therapy
A type ofradiation, calledhypofractionated radiation therapy, often follows breast surgery to kill any remaining cancer cells, reducing the risk ofrecurrence.
Hypofractionated radiation is different from conventional radiation in that higher doses of radiation are given over a shorter period. Conventional radiation consists of lower doses of radiation over six to seven weeks versus three to four weeks with hypofractionated radiation.
Hypofractionated radiation therapy offers the following advantages:
Verywell / JR Bee
Not all women with breast cancer need chemo, but there are several situations in which chemo is recommended:
There are different chemo drugs used for early-stage cancer, including 5-fluorouracil (5-FU) and Cytoxan (cyclophosphamide). Others commonly used for metastatic breast cancer include Adriamycin (doxorubicin and Cisplatin (platinum complex),
Black Women and Chemo Side EffectsFor reasons unknown, Black women are often more likely to experience chemotherapy side effects. Studies show thatperipheral neuropathy—often painful burning or pins-and-needles sensations—is twice as likely in Black women compared with White women.
Black Women and Chemo Side Effects
For reasons unknown, Black women are often more likely to experience chemotherapy side effects. Studies show thatperipheral neuropathy—often painful burning or pins-and-needles sensations—is twice as likely in Black women compared with White women.
Hormone therapyis often used as adjuvant therapy, typically for five years, to reduce the risk of cancer recurrence. It is also sometimes used as neoadjuvant therapy.
Drugs that block estrogen receptors include:
Drugs that lower estrogen levels include:
Targeted Drug Therapy
Targeted therapy involves drugs that target and bind to specific proteins on cancer cells to kill them or limit their growth.
These targets include a growth-promoting protein calledHER2and certain proteins found on ER+ breast tumors called CDK, mTOR, PI3K, and AKT.
Targeted drugs are also available for tumors with theBRCAgene mutationsand those classified astriple-negative breast cancer(which are negative for HER2, estrogen receptors, andprogesteronereceptors).
The list of targeted drugs used for breast cancer includes:
Chemotherapy vs. Targeted TherapyTargeted drug differs from chemotherapy in that chemo targets all fast-replicating cells, including cells in your skin, digestive tract, and hair follicles. Because of this, chemo can cause a wide range of systemic side effects, including skin changes, mouth sores, vomiting, and hair loss.Because the field of attack is narrower with targeted drugs, the side effects may be less extensive but no less profound.
Chemotherapy vs. Targeted Therapy
Targeted drug differs from chemotherapy in that chemo targets all fast-replicating cells, including cells in your skin, digestive tract, and hair follicles. Because of this, chemo can cause a wide range of systemic side effects, including skin changes, mouth sores, vomiting, and hair loss.Because the field of attack is narrower with targeted drugs, the side effects may be less extensive but no less profound.
Targeted drug differs from chemotherapy in that chemo targets all fast-replicating cells, including cells in your skin, digestive tract, and hair follicles. Because of this, chemo can cause a wide range of systemic side effects, including skin changes, mouth sores, vomiting, and hair loss.
Because the field of attack is narrower with targeted drugs, the side effects may be less extensive but no less profound.
Immunotherapyis a form of targeted therapy involving drugs that stimulate the immune system to work harder and smarter to detect and destroy cancer cells. Immunotherapy is sometimes combined with chemotherapy to treat triple-negative breast cancer, especially when itmetastasizes(spreads).
The drugs used are referred to asimmune checkpoint inhibitors. These target and block a protein called programmed cell death protein 1 (PD-1) that helps cancer cells hide from the immune system and grow unchecked.
There is currently one PD-1 inhibitor called Keytruda (pembrolizumab) which can be used for triple-negative breast cancer, either:
Special Report: Impact of Breast Cancer on Black Women
While Black women and White women get breast cancer at about the same rate, Black women are 40% more likely to die from the disease. Many factors contribute to this disparity, ranging from social and economic inequalities to genetics and tumor biology.
For reasons that are not entirely clear, Black women are also twice as likely to have triple-negative breast cancer, a rare but more aggressive form of cancer that does not respond to hormonal treatment. This accounts in part for the lower survival rates among Black women.
Black women also tend to get breast cancer at a younger age than their White counterparts. According to research:
This reinforces the U.S. Preventive Services Task Force’s recommendation of starting routinebreast cancer screeningas early as age 40.
Delays in diagnosis account in part for why Black women are more likely to be diagnosed with larger and more clinically advanced tumors. This means that the course of treatment is usually longer and more arduous than for White women.
Verywell / Julie Bang
Lack of Access to Quality Healthcare
Societal obstacles like a lack of insurance and lower socioeconomic status are significant contributors to delays frequently seen in breast cancer treatment for Black women.
A 2020 study published in the journalCancerfound that Black women have more delays in starting treatment than White women (13.4 % vs. 7.9% respectively) irrespective of their location, education, or socioeconomic status.
Other factors contributing to delayed diagnoses include a general mistrust of medical institutions, particularly public health clinics, and a history of biased medical practices (including the avoidance of more expensive therapies). These can impact a Black woman’s ability to comply with cancer treatments even when money is not a factor.
What You Can Do
Summary
Social and economic disparities can adversely affect treatment among Black women who have lower breast cancer survival rates. One way to improve outcomes is to start breast cancer screenings from as early as age 40. Doing so increases the chance of catching cancer early when it is most curable.
15 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Cancer Institute.Cancer fast stats: female breast cancer.
American Cancer Society.Breast cancer surgery.
Soni SE, Lee MC, Gwede CK.Disparities in use and access to postmastectomy breast reconstruction among African American women: a targeted review of the literature.Cancer Control.2017 Nov;24(4):1073274817729053. doi:10.1177/1073274817729053
American Cancer Society.Radiation for breast cancer.
Trogdon JG, Baggett CD, Gogate A, et al.Medical costs associated with metastatic breast cancer in younger, midlife, and older women.Breast Cancer Res Treat. 2020;181(3):653-665. doi:10.1007/s10549-020-05654-x
American Cancer Society.Chemotherapy for breast cancer.
Trendowski MR, Lusk CM, Ruterbusch JJ.Chemotherapy‐induced peripheral neuropathy in African American cancer survivors: risk factors and quality of life outcomes.Cancer Med.2021 Nov;10(22):8151–8161. doi:10.1002/cam4.4328
American Cancer Society.Hormone therapy for breast cancer.
American Cancer Society.Targeted drug therapy for breast cancer.
American Cancer Society.Chemotherapy side effects.
American Cancer Society.Immunotherapy for breast cancer.
Yedjou CG, Sims JN, Miele J, et al.Health and racial disparity in breast cancer.Adv Exp Med Biol. 2019;1152:31–49. doi:10.1007/978-3-030-20301-6_3
US Preventive Services Task Force.Screening for breast cancer: US Preventive Services Task Force recommendation statement.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
